[Efficiency of D2 radical resection combined with splenectomy in T3 cancer of upper stomach].
OBJECTIVE
To analyze the efficacy and influence of D2 radical resection combined with splenectomy in T3 cancer of upper stomach.


METHODS
From January 1980 to June 2002, 613 patients with T3 cancer of upper stomach received D2 radical resection. Of these cases, 102 underwent simultaneous splenectomy (splenectomy group), while 511 did not (spleen-preserved group). The metastatic rate of lymph nodes in splenic hilum and along the splenic artery (No. 10, No. 11), 5-year survival rates, recurrence rate, the postoperative complication rate and mortality rate were followed up and compared in the two groups.


RESULTS
The metastasis rate of No. 10 was 23.5% for splenectomy group and 14.9% for spleen-preserved group (P < 0.05). No significant difference was found in No. 11 metastasis between the two groups. The 5-year survival rate of splenectomy group was 39.8%, and was 32.3% in spleen-preserved group (P > 0.05). The recurrence rate of splenectomy group was 55.9%, and was 60.3% in spleen-preserved group (P > 0.05). In the splenectomy group, the 5-year survival rates were similar between patients with and without No. 10 metastasis (P > 0.05). The postoperative complication rate and mortality rate of the splenectomy group were 19.6% and 4.9%, and were 13.7% and 3.1% in the spleen-preserved group, respectively; and no significant difference was found between the two groups (P > 0.05).


CONCLUSIONS
D2 radical excision combined splenectomy should be recommended for stage T3 cancer of upper stomach when suspected with No. 10, No. 11 lymph nodes metastasis. Simultaneous splenectomy would not increase the postoperative complication rate and mortality rate.
Huang
Chang-Ming
CM
Department of Oncology, Affiliated Union Hospital, Fujian Medical University, Fuzhou 350001, China. hcmlr253@sohu.com
Lu
Hui-Shan
HS
Li
Ping
P
Xie
Jian-Wei
JW
Lin
Bi-Juan
BJ
Zhang
Xiang-Fu
XF
D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D011379:Prognosis; D013156:Splenectomy; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D016019:Survival Analysis; D016896:Treatment Outcome